Healthcare Revenue Cycle Management Market Size By Product (Integrated, Standalone), By Function (Claims & Denial Management, Medical Coding & Billing, Eligibility Verification, Payment Remittance), By Deployment (On-Premise, Cloud-Based), By End-use (Hospitals, Physicians, Diagnostic & Ambulatory Surgical Centers), Industry Analysis Report, Regional Outlook, Application Potential, Price Trends, Competitive Market Share & Forecast, 2019 – 2025

Published Date: Oct 2019  |  Report ID: GMI1170  |  Authors: Sumant Ugalmugale, Rupali Swain

Report Format: PDF   |   Pages: 130   |   Base Year: 2018




Summary Table of Contents Industry Coverage Methodology

Industry trends

Healthcare Revenue Cycle Management Market size surpassed $51 billion in 2018 and is expected to achieve over 12.3% CAGR up to 2025.
 

Healthcare Revenue Cycle Management Market

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Healthcare revenue cycle management is a financial process that utilizes billing software for tracking patients’ details. Now-a-days, due to increasing number of hospital admissions, healthcare professionals have started relying on the advanced revenue cycle management. These software helps to unify the administrative and clinical data that aids in providing holistic view regarding patient’s name, treatment information and insurance provider. Availability of upgraded software reduces manual errors, duplication of work and minimizes confusion while handling large data. Industry players are trying to focus on developing innovative HRCM software that would serve as one of the important components in healthcare system, not only enhancing patient engagement but also simplifying the workflow.
 

Healthcare revenue cycle management market can be traced back to 1920’s with the introduction of software for managing patient’s data that helped in reducing complications while handling large databases. In 1928, programs were developed to standardize the medical records. Later, as the technology advanced, healthcare information technology was revolutionized completely. Healthcare revenue cycle management software started gaining popularity even in diagnostic laboratories. Currently, the healthcare revenue cycle management industry is in developing stage and is predicted to witness numerous growth opportunities with advent of technology.
 

Healthcare Revenue Cycle Management Market Report Coverage
Report Coverage Details
Base Year: 2018 Market Size in 2018: 51 Billion (USD)
Historical Data for: 2014 to 2018 Forecast Period: 2019 to 2025
Forecast Period 2019 to 2025 CAGR: 12.3% 2025 Value Projection: 114 Billion (USD)
Pages: 130 Tables, Charts & Figures: 250
Geographies covered (19): U.S., Canada, UK, Germany, France, Spain, Italy, Russia, Japan, China, India, Australia, South Korea, Brazil, Mexico, Argentina, South Africa, Saudi Arabia, UAE
Segments covered: Product, Function, Deployment, End-use
Companies covered (14): Allscripts Healthcare Solutions, AGS Health, Athenahealth, Accretive Health, Cognizant Technology Solutions, Cerner, CareCloud, Conifer Health Solutions, Dell, Emdeon, Etransmedia, Experian
Growth Drivers:
  • Increasing healthcare expenditure in developed as well as developing economies
  • Growing demand for health insurance in North America
  • High preference for big data analytics
  • Technological advancements in HRM solutions
Pitfalls & Challenges:
  • Intellectual property rights issues

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Advancements in big data analytics facilitated management of complex healthcare data

Technological advancements in the HRCM software has positively influenced the industry growth throughout analysis timeframe. Recently developed software are highly efficient and helps in providing enhanced patient care. Moreover, upgraded HRCM software have reduced the outstanding accounts receivable of several hospitals and healthcare facilities. Furthermore, adoption of centralized software for medical billing and coding has reduced errors and enhanced the clinical outcomes. Therefore, availability of such technologically advanced systems has escalated the healthcare revenue cycle management market growth.
 

Lack of trained professionals for handling the HRCM software affects the industry growth to some extent. This factor will majorly impact the underdeveloped economies with lack of skilled professionals. However, it will have a short-term impact on the industry growth and will vanish with improvements in the healthcare system of underdeveloped economies.
 

Standalone HRCM software is predicted to foresee several growth opportunities in the near future

By product, HRCM market is classified into integrated and standalone. Standalone software/solution segment will experience around 8% CAGR during the analysis timeframe. The standalone solutions help in optimizing payment collection and claim settlement process. It helps to reduce overall cost and streamlines revenue that helps in efficient revenue cycle management. Moreover, increasing use of numerous standalone software databases and applications through a comprehensive network that will further favour segmental growth in upcoming years.
 

Availability of advanced HRCM software has facilitated the process of eligibility verification

Functions of HRCM software include claims & denial management, medical coding & billing, eligibility verification, payment remittance and others. Eligibility verification segment of healthcare revenue cycle management held over 17% revenue share. The patient eligibility verification process is a time-consuming process for clinics and hospitals. Therefore, healthcare professionals have started relying on HRCM software for carrying out eligibility verification software. The eligibility verification process verifies individual patient eligibility, payable benefits, deductibles, co-insurance, referrals & pre-authorizations and pre-existing clause. Moreover, process provides procedure-specific benefits and coverage and all out-of-pocket costs that will help patient collections. Adoption of HRCM for eligibility verification has reduced uncertainty about payment, insurance eligibility verification thereby enhancing patient satisfaction. Also, through eligibility verification process, healthcare providers can reduce the time required for patient check-in processes that stimulates the segmental growth.
 

Deployment of on-premise healthcare software has reduced the risk of data vulnerability

Healthcare Revenue Cycle Management Market Forecasts, By Deployment, 2018 (USD Million)
Healthcare Revenue Cycle Management Market Forecasts, By Deployment, 2018 (USD Million)

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By deployment, the HRCM market is segmented into on-premise and cloud based. On-premise segment of healthcare revenue cycle management market was valued around USD 11.5 billion in 2018 and will experience significant growth in the coming years. On-premise software platforms are installed on the user’s server or workstation. Generally, the on-premise software has high cost due to large investment in the equipment. However, the total cost of ownership is low because of less or no annual subscription fee. In addition, on-premise revenue cycle management solutions offers better data security and can be protected by preventing unauthorized access. Furthermore, it also offers greater control on data and backup process for data that proves beneficial for the segmental growth. Moreover, increasing focus of industry players on providing on-premise best-in-class pricing and billing management processes will increase its adoption thereby, augmenting the segmental growth.
 

Advanced HRCM models have revolutionized the workflow in hospitals

By end-use, HRCM market is classified into hospitals, physicians, diagnostic & ambulatory surgical centers, and others. Hospitals segment of HRCM market will experience over 12% growth during the forecast timeframe. Hospital segment is anticipated to show significant revenue cycle management market growth owing to increasing cash flows in hospitals. The number of patients are growing due to increasing prevalence of diseases, that compels healthcare providers to implement efficient revenue cycle management system for patient data collection. Hospitals try to optimize revenue by adopting technologically advanced HRCM software developed by companies that promotes efficient and effective management of patient’s clinical data and financial data. Above mentioned factors should escalate the segmental growth.
 

Increasing prevalence of chronic diseases in developed economies will prove beneficial for the healthcare revenue cycle management market growth.

Europe Healthcare Revenue Cycle Management Market Forecasts, By Country, 2018 (USD Million)
Europe Healthcare Revenue Cycle Management Market Forecasts, By Country, 2018 (USD Million)

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The U.S. HRCM market was valued at around USD 18 billion in 2018 and is yet to witness numerous growth opportunities in the forthcoming years. Increasing prevalence of chronic diseases one of the major factors driving country growth. Chronic diseases escalate the demand for healthcare services such as surgeries that subsequently increases the healthcare expenditures. In such cases, U.S. being a developed economy adopt technologically upgraded software for managing the data. Currently developed software assures data security and safety that will positively influence the demand for HRCM software augmenting the industry growth. Moreover, insurance providing companies such as Medicare and Medicaid have implemented benefit programs for geriatric population that increases the revenue investments in healthcare policies. This scenario also proves beneficial for industry growth as it elevates the demand for revenue management software for optimal revenue management.
 

Germany HRCM market will experience over 11.5% growth during the forecast period. Exponential country growth can be attributed to increasing geriatric population. Geriatric population is susceptible to chronic infections that positively influences the business growth. Moreover, improving regulatory scenario will ensure availability of superior quality HRCM software thereby, enhancing the industry growth.
 

Allscripts is one of the leading companies in healthcare revenue cycle management industry owing to continuous investments in technology upgradations

Some of the key industry players operating in the healthcare revenue cycle management market include Allscripts Healthcare Solutions, AGS Health, Athenahealth, Accretive Health, Cognizant Technology Solutions, Cerner, CareCloud, Conifer Health Solutions, Dell, Emdeon, Etransmedia and Experian. These industries implement several strategic initiatives for maintaining their market position.
 

Some of the recent industry developments:

  • In November 2018, Allscripts announced Veradigm as the new branding for life science division. Veradigm is a leading data driven health insights and analytical solution providing company. This partnership will allow Allscripts to enhance existing solutions and widen its customer base.
     
  • In November 2018, Carecloud announced that company has expanded its revenue cycle management service for more accurate billing and faster payments. This will allow company to enhance its business growth.
     

Healthcare revenue cycle management market research report includes an in-depth coverage of the industry with estimates & forecast in terms of revenue in USD from 2014 to 2025, for the following segments:

By Product

  • Integrated
  • Standalone

By Function

  • Claims & Denial Management
  • Medical Coding & Billing
  • Eligibility Verification
  • Payment Remittance
  • Others

By Deployment

  • On-Premise
  • Cloud-Based

By End-use

  • Hospitals
  • Physicians
  • Diagnostic and ASCs
  • Others

The above information is provided for the following regions and countries:

  • North America
    • U.S.
    • Canada
  • Europe
    • Germany
    • France
    • UK
    • Italy
    • Spain
    • Russia
  • Asia Pacific
    • China
    • Japan
    • India
    • Australia
    • South Korea
  • Latin America
    • Brazil
    • Mexico
    • Argentina
  • Middle East Asia & Africa
    • South Africa
    • Saudi Arabia
    • UAE
       

Frequently Asked Questions (FAQ) :

The healthcare revenue cycle management is a financial process that utilizes billing software for tracking patients’ details. These software helps to unify the administrative and clinical data that aids in providing holistic view regarding patient’s name, treatment information and insurance provider.
According to this report by GMI, global market for healthcare revenue cycle management is expected to register over 12% CAGR between 2019 and 2025.
On-premise segment of the global market was leading the industry with USD 11.5 billion revenue share in 2018.
Allscripts Healthcare Solutions, AGS Health, Athenahealth, Accretive Health, Cognizant Technology Solutions, Cerner, CareCloud, Conifer Health Solutions, Dell, Emdeon, Etransmedia and Experian are the major key players operating in the worldwide market for healthcare revenue cycle management.

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